Anabolic steroid use has been linked to depression and heart problems.
Photograph: Medicimage/REX Shutterstock

Britain is experiencing an epidemic of anabolic steroid use among image-obsessed young men, according to experts, who warn the country faces a health timebomb from a problem which is significantly underrepresented in official statistics.

The Crime Survey for England and Wales estimates that just under 60,000 people a year take the drugs, which mimic the effects of testosterone and boost muscle growth. But people who work with steroid users say the real figure could be many times greater, with the vast majority of users injecting the drugs and many doing so at gyms.

“It is a big underestimate,” said Professor Julien Baker, an expert in steroid use from the University of the West of Scotland. “There are needle exchanges in Cardiff and Glasgow which say they’ve seen a 600% increase for steroid users over 10 years. The real figure is definitely in the hundreds of thousands.”

With this comes a growing health toll, including an HIV infection rate among steroid users which has reached 1.5% – as high as that for injectors of drugs such as heroin – and growing rates of hepatitis B and C infection.

As well as the immediate effects of the steroids, which can include high blood pressure and aggression, those who work with users say people are taking increasingly high doses and for longer periods, putting them at risk of depression, heart problems and even long-term cognitive damage.

Used needles from steroid use at a gym in the north of England. Photograph: Guardian

Steroid users are also increasingly young, with one adviser seeing a 15-year-old who had injected the drug into his chest to try to bulk up, and anecdotal reports of boys as young as 13 using it.

Teenagers and young men feel increasingly pressured to match lean and muscular physiques portrayed in the media, experts say, making steroid use, once limited to sportspeople or obsessive bodybuilders, a mainstream choice. Many steroid injectors also use other substances, such as human growth hormone, insulin and other drugs to burn fat.

“The vast majority of people we see use steroids for image reasons,” said Gary Beeny, who works in a steroid clinic in the Ancoats district of Manchester. “It’s mainly to show your muscles, going out. It’s all linked to images of lean physiques with big arms. That’s the kind of look the young lads like.”

David Rourke, from the Arundel Street drugs project in Sheffield, said he had recently met a group of steroid-using men in their 20s. “One of them looked younger than the rest and he decided using steroids would make him start to grow a beard – which isn’t right at all. But he felt he wanted to do it, which is quite scary,” Rourke said.

The drugs, officially known as anabolic-androgenic steroids, were first developed for medical use, with early abusers mainly using illicitly acquired pharmaceutical supplies. While they remain a class C prohibited drug, experts say people can now easily buy them from fellow gym users or the internet, with underground factories supplying professionally packaged products with their own brand names and glowing online reviews. These can be taken as tablets but are more commonly injected into the skin or muscle.

“It used to be much more limited; only the really big, muscular guys went anywhere near steroids,” said Beeny. “Now it can be anybody who goes to a gym and speaks to people. The network of supply and demand is very advanced.”

Joseph Kean, the manager of the Bridge Project drug charity in Bradford, said the level of steroid abuse was “smashing through the roof”, with one needle exchange in Middlesbrough dealing with 2,000 people, the majority of them taking steroids. Surveys have found there are some gyms where 60-100% of people are believed to use the drugs.

“It’s everywhere,” Kean said. “I could go into any gym and find a steroid user. Even fitness clubs, the posh ones.”

While many gym chains were starting to put needle bins in changing rooms, some were in denial of the problem, he said.

“We ask if they want some information on steroids and they’ll say: ‘No one in our gym is using steroids.’ We’ll say: ‘Actually, five people using your gym have registered with us in the last month.’”

The response remains mixed among national gym groups. While one chain told the Guardian it was installing needle bins at all its clubs, another insisted it had never seen any evidence of steroid use among members.

The apparent ubiquity of steroid use spills over partly into sport, where more than half the athletes currently serving bans from UK Anti-Doping are rugby union or rugby league players. Many are young amateurs or lower-level players trying to bulk up to make the grade in an increasingly power-driven game.

But elsewhere, keeping track of the drug is difficult because many users, especially younger ones, don’t go to needle exchanges, and so are never officially recorded.

Public Health England describes steroid use as an emerging problem, admitting it is hard to establish trends. It is pushing local authorities to provide more syringe programmes and health testing.

Drug workers, meanwhile, are increasingly worried about young men taking large doses of steroids for long periods.

Beeny said: “People used to do cycles of six to eight weeks. Now they’ll often stay on all the time. As a young man what you’re essentially doing is switching off your natural, biological level of testosterone and then expecting it to come back when you stop using steroids.”

The effect of this can be depression, lethargy and low libido, which can in turn tempt people back to the drug, Beeny said.

Experts say steroid use is closely associated with other potential health risks, such as the use of recreational drugs and sexual promiscuity.

Kean said he fears the effects that will be seen when previously young and fit users start to age, even if they have stopped taking steroids. One recent study showed the drugs can damage ventricles in the heart, while another, co-authored by Kean, found steroid users had significantly worse spatial memory, raising the prospect of long-term cognitive damage from the drug.

“It’s got the potential to be a public health timebomb,” he said. “It’s only really now we’ve had people using for long periods. We really don’t know what’s going to happen.”

Case study: ‘I don’t know how I’m still here’

Adam started lifting weights when he was 16, doing so without any drugs for the first two years. But then a bodybuilding boss introduced him to steroids and his previously clean-living life – he did not drink or smoke – was transformed.

“I started getting a lot bigger, working on the doors, and I was getting more attention from girls,” he says. “I liked this lifestyle. I was taking steroids for six months at a time, and not taking any breaks, taking cocaine every weekend, always with different girls. That was my life, constantly, for about three years. I don’t even know how I’m still here today.”

Adam says the steroids changed his personality in other ways: “I had no criminal convictions. Then, in the space of about 12 months I got about 16, mainly connected to fighting. It was definitely the steroids that made me more aggressive. Your body, naturally, produces 7mg to 12mg of testosterone a day. I was putting in the region of 2,000mg to 3,000mg a week. All I wanted to do was be with different women, train and fight.

“It’s like being back in your teenage years. If you’re arguing with someone it’s a massive thing. You’re infatuated with the girl you’re with. You’re obsessive. It’s the same with your appearance. At my heaviest I was 18.5 stone, with 21 inch arms, but I didn’t think I was big. It was ridiculous.”

After a relationship broke down Adam stopped taking steroids, but then began again. It took a major health scare to make him stop for good. “I had high blood pressure and the doctor sent me to a specialist. They found I had an enlargement of the heart due to steroid abuse. They said: ‘If you don’t stop what you’re doing today, we’ll be diagnosing you with heart failure next month.’”

Now 31, Adam, based in the north of England, believes steroid use is endemic among teenage boys. “I can walk into a gym now and with the young lads it’s really obvious. With one or two it might be really good genetics, but you don’t get a group of seven or eight lads who look like they do without some other kind of help. It’s as simple as that.”